REUNION REGISTRATION FORM

 

                Harrisburg/Hershey, PA, NPCA Reunion Registration

 Name:  
Postal Rate/Position:  
Dates of Service:  
Guest Names:  
E_mail  
Tel:  
 

                                                       INSTRUCTIONS

Registration cost is $70.00 for each attendee member or guest.  Registration includes hospitality suite for four days and banquet.  There is also an $77.00 cost for the Amish Farmland Tour.  Send completed registration form, registration fees, amount for the tour and association dues, if applicable, to the association Treasurer, Terry Baardsgaard.   Mailing address:

NPCA Treasurer

Terry Baardsgaard

200 Campus Dr

Moyock, NC 27958

 
 

 

ATTENDEES   (Includes guest)           ______     X      $ 70.00 = ________________

 

Amish Farmland Tour (Optional)        ______     X      $ 77.00 =  ________________

 

Bi-Annual Dues (Optional)                                            $ 20  =  ________________

              or

Lifetime Membership                                                     $ 50  =   ________________­

 

TOTAL:                                                                                       ________________

 

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